An Apple a Day Prevention as A Treatment for MS CMSC 2015 Mary Kay Fink, ACNS-BC, MSN, MSCN The MS Center of Saint Louis
Preventive Healthcare Preventive healthcare (alternately preventive medicine or prophylaxis) consists of measures taken for disease prevention, as opposed to disease treatment. Just as health encompasses a variety of physical and mental states, so do disease and disability, which are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices. Disease prevention relies on anticipatory actions that can be categorizes a primary, secondary, or tertiary prevention. Primary, Secondary, Tertiary Primary prevention: Methods to avoid occurrence of disease either through eliminating disease agents or increasing resistance to disease. Secondary prevention: Methods to detect and address an existing disease prior to the appearance of symptoms. Tertiary prevention: Methods to reduce negative impact of symptomatic disease, such as disability or death, through rehabilitation and treatment. http://en.wikipedia.org/wiki/preventive_healthcare
Primary Care Primary care: A patient's main source for regular medical care, ideally providing continuity and integration of health care services. The aims of primary care are to provide the patient with a broad spectrum of preventive and curative care over a period of time and to coordinate all the care that the patient receives. An ongoing partnership. Does our health care system allow for this? http://www.medicinenet.com/script/main/art.asp? articlekey=5042 Primary Care is a Means to Prevention Studies show that people who receive regular primary care are healthier compared to those who don t. Yet many people, especially younger, healthier individuals, seem to forego annual check-ups with their Health Care Provider (HCP) http://www.bmc.org/about/news/featurestories-primary-carebenefits-your-overall-health.htm#sthash.tm0ebm1h.dpuf
Why are health screenings important? Early detection is key - Many serious conditions, such as heart disease and diabetes, don t show symptoms or warning signs. Even minor health problems should be checked out in case they lead to something more threatening. Cost Containment- Preventive care is usually less expensive than treating a health problem once it has started. Annual check-ups and health screenings help people stay healthy and avoid expensive care for full-blown illnesses. Avoid serious illness - Many diseases, even serious, are preventable through a healthy lifestyle. People can learn how to eat a balanced diet, get plenty of physical activity and get help to stop smoking or moderate alcohol use. https://www.northshorelij.com/find-care/services-we-offer/primary-care/health-screenings
Screenings Screening tests look for diseases before one has symptoms. They can identify diseases early, when they are easier to treat. Screenings should include: High blood pressure Diabetes High cholesterol Risk for cardiovascular disease Overweight and obesity Osteoporosis Colorectal cancer Breast and cervical cancer Prostate cancer Preventive & screening services? Medicare Part B (Medical Insurance) covers: Abdominal aortic aneurysm screening Alcohol misuse screening and counseling Cardiovascular disease screening and behavioral therapy Cervical and vaginal cancer screening Depression screening Diabetic screening and management training Glaucoma test Hepatitis C screening HIV screening Mammograms screening Nutrition therapy services Obesity screening and counseling Prostate cancer screenings Sexually transmitted infections screening and counseling Tobacco use cessation counseling Yearly Wellness visit Shots Flu shot Hepatitis B Pneumococcal
Annual Skin Assessments Annual Eye and Vision Exams
Should we care? MS HCPs embrace the concepts of prevention and wellness A healthy MS patient with less co-morbid conditions is easier to treat Primary care is an important intervention for those with Progressive MS-( Patricia Coyle CMSC 2014) And to all with MS- (MK Fink CMSC 2015) Take a minute and ask Do you have a PCP? Have you had an annual exam, recently? Are your vaccines up to date? Flu shot? Have you had a pap/mammogram recently? PSA for males? Have you had a bone density? Have you had a colonoscopy? Skin exam? Vision and eye exam? Dental Screening? Hearing Exams?
Possible alternative to colonoscopy Stool DNA Testing for Colon Cancer The FDA approved the DNA stool test, called Cologuard, in August 2014, and the Centers for Medicare & Medicaid Services (CMS) decided in October 2014 to cover it. No special diet or bowel preparation (no laxatives or enemas) are required for a stool DNA test. However, if the Cologuard test does indicate cancer or pre-cancer, the patient would then need a colonoscopy to confirm it, and possibly to remove any polyps.
Take a minute and counsel Importance of healthy diet Ideal body weight Fruit, fiber, and fluids Calcium Vit D Omega 3 fatty acids Avoid saturated fats Limit alcohol consumption Lower sodium intake Take a minute and counsel About the benefits of exercise and activity Smoking Cessation Illicit drug use Risk taking behaviors- including sexual behaviors Screen for depression and other mental health disorders Abuse and neglect
The only way to keep your health is to eat what you don't want, drink what you don't like, and do what you'd rather not Mark Twain Resources Screening tools Institution EMR/Meaningful use AHRQ/US Preventive Service Task Force Mobile tools Referral Base Colleagues IOMSN Community Agencies Resource for patients http://familydoctor.org/fa milydoctor/en/preventionwellness/stayinghealthy/healthyliving/preventive-servicesfor-healthyliving.printerview.all.html Community Agencies Healthcare Centers
The aim of medicine is to prevent disease and prolong life, the ideal of medicine is to eliminate the need of a physician. - William J. Mayo